Combination Therapy for Metastatic Head and Neck Cancer

For most people, cancer treatment involves surgery, killing cancer cells with strong drugs (chemotherapy), or radiation. They’re still the main ways doctors treat many forms of cancer because they usually work pretty well.

But when cancer spreads throughout the body, like metastatic squamous cell carcinoma of the head and neck (HNSCC), it gets harder to treat. Research shows that newer types of “targeted therapy” may work well for people with these advanced stages of cancer. Targeted therapy is a type of treatment where drugs or other substances can find and attack cancer cells, but cause little or no damage to normal cells.

Immunotherapy is a specific type of therapy that uses your immune system to fight cancer. It can work especially well for metastatic HNSCC.  

You can take immunotherapy treatments on their own, but you can also take them along with other treatments. This is called “combination therapy.” It may include:

  • Chemotherapy and immunotherapy
  • Immunotherapy and other forms of targeted therapy
  • Two types of immunotherapy

As part of your overall cancer treatment, your doctor may recommend other steps, too, like surgery or radiation.             

Does Combination Therapy Work Better?

Any treatment will work differently for each person who takes it. But many cancer experts think combination therapy is especially promising for tough-to-treat forms of it, like metastatic HNSCC.

For example, one study found that treatment with an immunotherapy drug called nivolumab and chemotherapy worked better than chemotherapy alone for people with metastatic HNSCC.

Still, doctors need more research to figure out which approaches are most effective. That’s why experts around the world are doing clinical trials to test immunotherapy drugs on their own and combined with other treatments.

Is Combination Therapy Right for You?

Doctors usually prescribe immunotherapy after you’ve had chemotherapy or radiation. In many cases, it’s because those treatments didn’t work well enough.

With metastatic HNSCC, though, your doctor may recommend targeted therapies, including immunotherapy, as an early treatment. That’s because experts know that when squamous cell carcinoma has spread (metastasized) to other areas of your body, it can be hard to treat with just surgery, chemotherapy, or radiation. Some types of immunotherapy, either in combination or alone, may work better.

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Your cancer doctor and care team will talk to you about your treatment options. The FDA hasn’t approved most combination therapy for HNSCC. Instead, scientists are testing combinations in clinical trials. If your doctor or medical team thinks you may be a good fit for combination therapy or a clinical trial, she will help you take the next steps to start it. (If your doctor doesn’t bring up immunotherapy, ask if it may be an option for you. You can also get a second opinion at a medical center that uses immunotherapy.)

As with all types of cancer treatment, your doctor and care team will look after your health closely while you’re having combination therapy. If the treatments don’t give the results you and your doctor were hoping for, your team will work together to find other treatments for you to try.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on March 31, 2019

Sources

SOURCES:

Cancer Research Institute: "Head and Neck Cancer."

American Cancer Society: "What is Cancer Immunotherapy?" "Targeted Cancer Therapy.”

National Cancer Institute: "Targeted Cancer Therapies."

Cancer Immunology Research: “Immunity in Head and Neck Cancer.”

Nature Reviews Cancer: “Combining immunotherapy and targeted therapies in cancer treatment.”

University of Texas M.D. Anderson Cancer Center: "Review highlights potential of cancer immunotherapy plus targeted therapy."

The New England Journal of Medicine:  “Nivolumab for Recurrent Squamous-Cell Carcinoma of the Head and Neck.”

Cancer Research Institute: "Head and Neck Cancer."

University of California, San Francisco: "Metastatic Squamous Cell Carcinoma.”

Cleveland Clinic: "Metastatic Squamous Neck Cancer with Occult Primary."

Milan Radovich, PhD, medical co-director, Indiana University/IU Health Precision Genomics Program, Indianapolis.

Elizabeth A. McGlynn, PhD, vice president, Kaiser Permanente Research, Oakland, CA.

© 2019 WebMD, LLC. All rights reserved.

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